Addressing Problems With Medicaid Home And Community-Based Services In The Age Of Rebalancing

Health Affairs October 1, 2024
Katherine Rohde, Norma B. Coe, Pilar Gonalons-Pons, Katherine Miller, Amanda R. Kreider, Allison K. Hoffman

Abstract

For nearly a half-century, Congress has created various legal authorities from among which states may select to provide Medicaid beneficiaries with long-term services and supports (LTSS) in home and community-based settings, instead of in institutions. This article describes these legal authorities and their genesis and contends that a simpler architecture would better serve program goals. In theory, state-level variation could shine a light on how Medicaid can best...

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